CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Flowers Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,120
  • Cash Discount Price: $2,432
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Flowers Hospital is $1,120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,432. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.18x the Medicare baseline. Located in 4370 West Main Street, Dothan, AL.
Cash / Self-Pay
$2,432

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,120

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)
Cash / Self-Pay: $2,432 (256%)
Insurance Median: $1,120 (118%)
Cash: $2,432 (256% of Medicare)
Ins. Median: $1,120 (118% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Veterans Eval Services $294 31%
Alabama Rehab $383 40%
Medicaid / KanCare $383 - $631 40%
Tricare $851 90%
Blue Cross Blue Shield $882 - $1,421 93%
Humana $882 93%
Medicare (plans) $882 93%
Node Viva Mcr Adv $882 93%
UnitedHealthcare $882 - $3,200 93%
Select Health $890 94%
Compassionate Hands $896 94%
Covenant Hospice $896 94%
Dayspring Hospice $896 94%
Node Champva $896 94%
Node Hospice Non Par $896 94%
Node Va $896 94%
Southern Care Hospice $896 94%
Vistacare Hospice $896 94%
Wiregrass Hospice $896 94%
Care Improvement Plus $899 95%
Cigna $899 - $1,882 95%
Node Devoted Health Mcr Adv $899 95%
Node Clover Health Mcr Adv $905 95%
Aetna $908 - $11,833 96%
Node Wellcare Mcr Adv $914 96%
Eon Health Care $926 97%
Prime Health $943 - $11,436 99%
Node Us Dept Of Labor $1,120 118%
Ambetter / Centene $1,344 141%
Occunet $1,568 165%
Self Pay $2,432 256%
Choicecare Commercial $3,500 368%
S & S Healthcare $4,053 427%
Viva Health $5,219 549%
Multiplan $5,578 - $12,968 587%
American Employee Alliance $6,484 682%
Coventry Healthcare $8,105 - $12,378 853%
Standard Textile $11,347 1194%
Alamed Wc $11,436 1204%
Health Choice $11,833 1245%
Equian $12,158 - $12,782 1280%
Qhp $12,158 1280%
Novanet $12,968 1365%
Alabama Work Comp $13,454 1416%
Ccn/Mednet Ppo $13,779 1450%
Corvel $13,779 1450%
Industry Buying Group $13,779 1450%
Galaxy Health $14,589 1536%
Health Payors Org $14,589 1536%
National Provider Net $14,589 1536%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4370 West Main Street, Dothan, AL 36302
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals